前列腺潜伏癌及偶发癌的病理学特征研究

Study on the pathological characteristics of latent carcinoma and incidental carcinoma of the prostate

目的研究前列腺潜伏癌及偶发癌肿瘤形态学、增殖状态及基质金属蛋白酶-2（MMP2）、MMP-9表达与临床癌的差异。方法收集前列腺潜伏癌组织标本24例、偶发癌组织标本5例、临床癌组织标本38例，常规染色观察其组织学特征，免疫组织化学SP，法检测Ki-67、细胞增殖核抗原（PCNA）、MMP-2、MMP-9的表达。结果潜伏癌及偶发癌组Gleason评分较低，临床癌组的评分较高。潜伏癌及偶发癌组中有核仁者为62．1％（18／29），明显低于临床癌组的94．7％（36／38）（P〈0．05）。潜伏癌及偶发癌组Ki67及PCNA的表达率为0及13．8％（4／29），均明显低于临床癌组的54．8％（17／31）及91．9%（34／37）（P〈0．05）。临床癌组中MMP-2、MMP9的阳性表达率分别为73．0％（27／37）、68．4％（26／38）．明显高于潜伏癌及偶发癌组的23．8％（5／21）、28．6％（4／14），差异有统计学意义（P〈0．05）。结论前列腺潜伏癌及偶发癌在组织结构、核仁特点、增殖状态及MMP-2、MMP-9表达均与临床癌有所不同。前列腺潜伏癌及偶发癌与临床癌可能是有不同分化程度、不同增殖活性及：不同侵袭性的两类病变。

Objective To study the differential characteristics of morphology,proliferating degree and expression of MMP2, MMP-9 between latent, carcinoma,incidental carcinoma and clinical carcinoma of the prostate. Methods The morphological features were observed by HE staining and the expressions of Ki-67,PCNA, MMP-2, MMP-9 were studied by immunohistochemistry （SP method） in 24 cases of latent carcinomas, 5 cases of incidental carcinomas and 38 cases of clinical carcinomas. Results The Gleason scores of latent carcinomas and incidental carcinomas were lower than those of clinical carcinomas （P〈0.05）. The number of nucleoli of clinical carcinomas was significantly greater than those of latent carcinomas and incidental carcinomas （94.7% vs 62.1% P〈0.05）. And the expressions of Ki-67 and PCNA （0 and 13.8% ） of latent carcinomas and incidental carcinomas were significantly lower than those （5.8%and 91.9%） of clinical carcinomas （P〈0.05）. The positive expression rates of MMP-2 and MMP-9 in clinical carcinomas were 73. 0%（27/37）and 68.4%^（26/38）, respectively, which were significantly higher than those of 23.8% （5/21） and 28, 6 % （4/14） in latent carcinomas and incidental carcinomas （P〈0.05）. Conclusions Latent carcinoma and incidental car cinoma are quite different from clinical carcinoma in some aspects. The high expressions of MMP 2 and MMP-9 may play an important role in the invasion of clinical carcinoma of the prostate, Latent carcinoma,incidental carcinoma and clinical carcinoma may be 2 distinct entities with different differentiations, different proliferations and different behaviors.